The little heard voices of Indian war surgeons
Dr Ashok Sankhpal is a medical doctor who was posted for nine months near Al Ramtha in Jordan- very close to the Syrian border, not the safest place to be in at this point in time. He expresses the horror thus: “I could hear the bombings every day and with every bomb explosion, about 50 people would die. This feeling was extremely stressful.”
Dr Sankhpal is one of the Indian doctors who take sabbaticals from their medical practice to volunteer with the global NGO- Doctors Without Borders(DWB) that work in war-torn regions.
Though he has been to four medical missions before this- in Ethiopia, Zimbabwe, South Sudan and Uzbekistan, this was the first time he worked in a conflict ridden region.
Over 6 Lakh Syrians have their heart set on fleeing the war and to seek asylum in Jordan across the border. It’s in Amman- the capital of Jordan that the NGO runs a reconstructive surgery program.
The patient’s chance to access even the most basic medical aid in a war zone is determined largely by their socio-economic status. In Dr Sankhpal’s words, ““In a conflict zone, you can only cross the border if you have support of the local fighting clan. Some come with influence and power, but half of the patients die because of the scrutiny and the waiting period.”
Another conflict, similar tragedies
Dr kalyani Gomathinayagam has been working with DWB since 2010. One of her postings has been at war torn Yemen where DWB provides surgical care in Al Azaraq and Qataba’a districts of Ad Dhale governorate.
“At least in an epidemic outbreak, patients are assured access to healthcare facilities, unlike in a conflict zone where various factors could become hurdles to better access,” she said.
She has served in Yemen twice(in July 2015 and in December 2016)- an experience which makes her feel that the civil conflicts have changed the societal structure for good : “Schools have not opened for over two years. The civilians and children are taking up arms. A 14-year-old boy has been fighting. He was injured and we had to amputate his leg to save him.”
Dr Kalyani used to serve in the paramilitary services but was later deputed to the Republic of Congo in Africa as part of the UN peacekeeping force. “Not all doctors have a military background but it makes it easier to adapt to the changing circumstances in the field,” she said.
Dr Bhavna Chawla is yet another Indian doctor who works with DWB. The work with the organization goes with her core ethos- to treat the patients regardless of their caste, religion or nationality.
She says how sometimes you treat both the victim and the perpetrator of a crime under the same roof, as also those from opposing religious affiliations who don’t necessarily see eye to eye.
Being a military surgeon for a decade, Dr Bhavna’s first medical mission was at the conflict-stricken newest country in the world,South Sudan back in April 2015.
Dr Bhavna Chawla, performing a surgery in Lankien, South Sudan
The horrors of war, through the doctor’s eyes
Attack on healthcare facilities and workers make treating in war-torn regions nothing short of a nightmare. As the situation in Syria continues to deteriorate, more patients come to Jordan for medical care.
According to Dr Sankhpal, working in Jordan has been one of the most unique and challenging experiences since he received the most complicated head and spinal injury cases.
“In Syria, doctors are operating in basements inside homes with no electricity. The doctors operate with torch-lights. There’s no blood bank to store blood. The locals donate blood in a blood bag, which is matched with the blood group without being screened for diseases. It is the only way to save a dying man’s life,” he said.
Many people needed to be transported out of the country for complicated medical treatment. However, only very few could make it out. “A six-year-old boy was awaiting a bone marrow transplant, which doesn’t exist in Yemen, so he has to go to Saudi Arabia. It is sad that he has to visit every 3-4 days as the body destroys the red blood cells in two days,” said Dr Kalyani
Chad is another African country where conflicts and civil wars have made life hell. “There are mothers who bring their children on donkeys travelling for 25 kilometres. They cannot even sit astride as it is forbidden in their culture. The hardships they undergo to access
services makes one wonder what keeps them going.” said Dr Kalyani.
And of course, there are the crucial judgement calls that need to be made.
“Sometimes we had to be so cruel that we wouldn’t take the patient to the Operation Theatre (OT) because we know he is going to die in a few minutes. We could not take a chance to use resources on surgery which is not going to be successful at all,” said Dr Sankhpal.
Dr Chawla reminisces about her experience working with a programme for infectious diseases and malnutrition in Lankien, South Sudan: “The war erupted suddenly between several clans and tribes. We were swamped for over next one and a half month. In the 70-bedded hospital, there were only 25 beds for surgery. We got 10-12 patients coming on their own every day. We were treating over 100 patients with gunshot wounds each month.”
“There was no Intensive Care Unit. I was doing an orthopedic procedure but I could not take an x-ray to confirm if what I have done is right,” she added.
She goes on to explain how water shortage was an acute issue for the better part of her mission. They survived on water donated by another organization. And in Lankien, since there was no electrical supply, the ‘facilities’ which functioned in inflatable tents had to run on generators.
In wars as in many other conflicts, it’s the children who suffer the most.
In Dr Sankhpal’s words, “Many children who come to MSF are below the legal age of 18. Some are unaccompanied. We don’t know who they are because their parents have died in the bombing. We have to find relatives who can care for them. It is really touching to see how the war is affecting the lives of the people in such regions.”
“You don’t have the time to reflect on why people are fighting, you move with patients who need your attention. They don’t have a voice and we are the only witnesses to what is happening here. They are cut off from the media and from the rest of the world,” says Dr Kalyani. “When you leave the mission you feel there is a lot to be done here. I have never returned from a project and said that I did everything to help them,” she added.
Image credits: Medecins Sans Frontieres
With inputs from dnaindia